Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period

Background: This study reports the practices and morbidity of 24 165 anaesthetics performed over a 30-month period in a paediatric teaching hospital. Methods: Data describing practices and adverse events during anaesthesia and in the postanaesthesia care unit (PACU) were collected prospectively from 1 January 2000 to 30 June 2002 on an audit form as a part of the Quality Assurance Program. All surgical specialties are covered except for open heart surgery and neurosurgery. Results: A total of 724 adverse events were reported during anaesthesia and 1105 in PACU. Respiratory events represented 53% of all intraoperative events. They were more frequent in infants compared with older children, in ENT surgery compared with other surgery, in children in whom the trachea was intubated and in children with ASA status 3-5 compared with those with ASA score 1 or 2. Cardiac events accounted for 12.5% of intraoperative events and were mainly observed in children with ASA score 3-5. In PACU, vomiting was the most frequent adverse event with an overall incidence of 6%. Vomiting was more frequent in older children compared with infants and young children and more frequent after ENT surgery compared with other surgery. Only one death was reported in a premature newborn infant and was not anaesthesia-related. Conclusions: This observational study confirms previous reports, and indicates that there is still a relative higher rate of adverse events in infants compared with older children even in a teaching paediatric hospital with a high annual caseload.